脉络宁注射液、通督调神针刺法联合常规治疗对短暂性脑缺血发作患者的临床疗效

Clinical effects of Mailuoning Injection,Tongdu Tiaoshen Acupuncture Method combined with conventional treatment on patients with transient ischemic attack

目的探讨脉络宁注射液、通督调神针刺法联合常规治疗对短暂性脑缺血发作患者的临床疗效。方法129例患者随机分为对照组A、对照组B、观察组,每组43例,分别给予常规治疗(低分子右旋糖酐、阿加曲班等)、常规治疗+脉络宁注射液、常规治疗+脉络宁注射液+通督调神针刺法,疗程1个月。检测临床疗效、中医证候评分、脑氧代谢指标(CjvO_(2)、SjvO_(2))、脑部血流指标(LVA、RVA、BA血流速度)、凝血指标(APTT、PLT、PT、FIB)、血管内皮功能指标(vWF、VEGF、ET-1、NO)、LP-PLA2、ADMA、Hcy、IL-33、MMP-9、不良反应发生率变化。结果观察组总有效率高于对照组A、对照组B(P<0.05)。治疗后,观察组中医证候评分、vWF、ET-1、LP-PLA2、ADMA、Hcy、MMP-9低于对照组A、对照组B(P<0.05),脑氧代谢指标、脑部血流指标、VEGF、NO、IL-33更高(P<0.05),APTT、PT更长(P<0.05),PLT更短(P<0.05)。3组不良反应发生率比较,差异无统计学意义(P<0.05)。结论脉络宁注射液、通督调神针刺法联合常规治疗可安全有效地改善短暂性脑缺血发作患者脑血流指标及血清Hcy、IL-33、MMP-9水平,缓解临床症状。

AIM To explore the clinical effects of Mailuoning Injection,Tongdu Tiaoshen Acupuncture Method combined with conventional treatment on patients with transient ischemic attack.METHODS One hundred and twenty-nine patients were randomly assigned into control group A(43 cases)for 1-month intervention of conventional treatment(low molecular dextran,argatroban anhydrous,etc.),control group B(43 cases)for 1-month intervention of conventional treatment+Mailuoning Injection,and observation group(43 cases)for 1-month intervention of conventional treatment+Mailuoning Injection+Tongdu Tiaoshen Acupuncture Method.The changes in clinical efficacy,TCM symptom scores,cerebral oxygen metabolism indices(CjvO_(2),SjvO_(2)),cerebral blood flow indices(blood flow velocities in LVA,RVA,BA),coagulation indices(APTT,PLT,PT,FIB),vascular endothelial function indices(vWF,VEGF,ET-1,NO),LP-PLA2,ADMA,Hcy,IL-33,MMP-9 and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group A and control group B(P<0.05).After the treatment,the observation group demonstrated lower TCM symptom scores,vWF,ET-1,LP-PLA2,ADMA,Hcy and MMP-9 than the control group A and control group B(P<0.05),along with higher cerebral oxygen metabolism indices,cerebral blood flow indices,VEGF,NO and IL-33(P<0.05),longer APTT,PT(P<0.05)and shorter PLT(P<0.05).No obvious difference in incidence of adverse reactions was found among the three groups(P>0.05).CONCLUSION For the patients with transient ischemic attack,Mailuoning Injection,Tongdu Tiaoshen Acupuncture Method combined with conventional treatment can safely and effectively improve cerebral blood flow indices and serum Hcy,IL-33,MMP9 levels,and alleviate clinical symptoms.